CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Rush Memorial Hospital

Billing Code: 45380 (CPT)

The BaseRate · fair price low confidence

A fair price for this

$320

about 0.3× the $1,223 Medicare rate · typically $184–$2,689

modeled estimate · not a bill or quote

What this hospital charges insurers

$195

Below the fair price — a good deal

about $125 under the fair price · 0.2× Medicare

Medicare pays $1,223 Fair price $320 This hospital $195 Cash price $1,885 Hospital's list price $2,513

How we calculate the fair BaseRate →

How this hospital compares to other IN hospitals

A typical price — 4 charge more and 4 charge less, among the 9 IN hospitals compared.

Cheapest $167 Priciest $297

Black dot = this hospital, among the 9 IN hospitals with a price for this procedure. Full list below.

⚠ The cash price looks unusually high next to the insurance price — it may be the full list price, not a real cash discount. Call to confirm the self-pay rate.

A fair price for a Colonoscopy with biopsy is about $320 (about 0.3× the $1,223 Medicare rate). Rush Memorial Hospital charges insurers about $195, or about $1,885 in cash — below the fair price — a good deal. Located in Rushville, IN.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

5 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana Kaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$145 - $167	12%
Blue Cross Blue Shieldmajor	$172 - $623	14%
Aetnamajor	$169 - $195	14%
Cignamajor	$1,256	103%
Humanamajor	$169 - $180	14%
CareSource	$167 - $225	14%
Health Net	$1,256	103%
+ 5 smaller / regional plans	$172 - $712

Excludes 4 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 1,885), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 45380.

Insurance Before you use insurance

Call your insurance company to confirm Rush Memorial Hospital is in-network.
Ask your insurer whether prior approval is required for CPT code 45380.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at Rush Memorial Hospital

Compare: Colonoscopy with biopsy at other IN hospitals

Insurance negotiated median for the same procedure, sorted lowest first.